Testosterone Replacement Therapy in Sexual Dysfunction

For men suffering from sexual dysfunction and low testosterone levels, testosterone replacement therapy (TRT) is recommended in clinical practice guidelines. Nevertheless, the use of this therapy in men with sexual dysfunction but unknown testosterone status is common yet poorly assessed. A literature review and meta-analysis were conducted to evaluate this therapy in men with sexual dysfunction, compared to placebo or other medical treatments. A total of 43 studies involving 11,419 participants were included. The authors distinguished between short-term results (less than 12 months) and long-term results (beyond one year). Three scenarios were compared: TRT versus placebo, TRT versus PDE5 inhibitors, and TRT + PDE5 inhibitors versus placebo. In the short term, TRT probably has little or no effect on erectile function, sexual quality of life, or cardiovascular mortality compared to placebo.